Healthcare Provider Details

I. General information

NPI: 1225355118
Provider Name (Legal Business Name): AMCE PHYSICIANS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 04/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 26TH ST SUITE 14
OGDEN UT
84401-3119
US

IV. Provider business mailing address

205 26TH ST SUITE 14
OGDEN UT
84401-3119
US

V. Phone/Fax

Practice location:
  • Phone: 800-440-3305
  • Fax: 877-468-4543
Mailing address:
  • Phone: 800-440-3305
  • Fax: 877-468-4543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: WES DAVIS
Title or Position: CEO
Credential:
Phone: 800-440-3305